Assessment of Factors Associated with Health Literacy Among Afghan Refugees in Pakistan

Introduction: Health literacy enables refugees to assess, understand, and utilize health information effectively. This investigation aims to identify factors influencing health literacy levels among Afghan refugees in Pakistan. Methods: A cross-sectional survey using a multistage sampling approach was conducted to collect data from 1185 refugees. Health literacy levels were measured using the pre-validated All Aspects of Health Literacy tool in five districts of Punjab and Khyber Pakhtunkhwa provinces that met the inclusion criteria. We used logistic regression models to analyze the dichotomous dependent variables. Results: A significant proportion of Afghan refugees demonstrated low functional health literacy and required assistance with reading and completing health documentation. Afghan refugees in the younger age group, male gender, higher monthly income, and access to healthcare information and clean water were more functionally literate in health. More than two thirds of the Afghan refugee population had adequate communicative health literacy with health care professionals in Pakistan. Most refugees believed that healthy lifestyles information and encouragement were more crucial for health than housing, employment, education, and local infrastructure. Conclusions: Afghan refugees in Pakistan lacked functional health literacy, critical health literacy, and overall health literacy. However, they have adequate communicative health literacy. This initial survey added new data on Afghans' health literacy levels, which could help stakeholders strengthen health promotion initiatives within the healthcare system to improve health outcomes.